Manual ventliation or resuscitation device

ABSTRACT

A manual ventilation or resuscitation device is provided. The body of the device has rigid panels that encompass a sealed volume and are movable with respect to each other. The body has a displacement in a direction of a hand displacement and at least one other direction. A size adjuster adjusts the body displacement(s) between the states. A frequency adjuster adjusts the time to restore the volume or to adjust the time to compress the volume. The body provides an ergonomic fit to a user&#39;s hand, which reduces fatigue. The volume and/or frequency adjustments provide a user with reliance on a more or less constant tidal volume and tidal rate. Such adjustments allow usage of the device on any patient, regardless of individual factors such as physical condition, body/lung size, age and sex. Multiple devices could easily be stacked or nested with each other, which reduces storage space.

This application claims priority under 35 U.S.C. § 120 as a continuationof U.S. patent application Ser. No. 11/147,070 filed Jun. 6, 2005,currently pending, and the disclosure of which is incorporated byreference in its entirety.

FIELD OF THE INVENTION

The present invention relates generally to manual ventilation orresuscitation devices. More particularly, the invention relates tomanual ventilation or resuscitation devices with control over the amountand rate of e.g. air, oxygen or oxygen-enriched air delivered to anindividual and with a design that easily fits a user's hand.

BACKGROUND OF THE INVENTION

Manual ventilation or resuscitation is performed on an individual whenthey are unable to breathe independently. Typically, this occurs when anindividual is transported from one section of a hospital to anothersection such as an emergency room and an intensive care unit. Manualresuscitation also occurs during cardiopulmonary resuscitation (CPR),which is a standard technique applied to victims of cardiopulmonaryarrest with the goal to re-establish normal cardiac and respiratoryfunction.

Ventilation from a manual resuscitation device is currently provided bya self-filling elastomeric enclosure or bag. This bag is compressible byhand, a face-fitting mask (or intubation tube) in fluid communicationwith an outlet passage of the bag, and a one-way valve between the maskand bag to permit only fluid passage from the bag to the mask. The bagalso has an inlet passage, typically with one opening for air andanother, usually smaller opening for receiving oxygen. By squeezing thebag with their hand(s), a clinician delivers air or oxygen to anindividual, then releases the bag to permit it to expand to full sizeand thereby draw air or oxygen through the inlet passage.

The amount of air received by the lungs of the individual corresponds tothe volume of the bag. A larger bag provides a greater maximum volume ofair to be pumped into the individual. Children and infants typicallyhave smaller lungs than an adult, and therefore conventional manualresuscitation devices are provided in different sizes; e.g. infant,child and adult. Each size provides a different maximum volumetricoutput of air. Depending on factors such as physical condition, bodysize, age, sex, etc., each individual may require a specific volume ofair, i.e. tidal volume, and frequency, i.e. tidal volume/minute.

Unfortunately, current manual ventilation or resuscitation devices arenot suitable for the desired monitoring and control of tidal volumedelivery. For instance, the collapsible bag portion of the resuscitationdevice allows the user to merely “feel” the amount of air they areproviding to the individual. This provides them a rough estimate of thevolume of air they are providing and a tactile feel for when the lungsare non-compliant, i.e. are being pressurized. Although self-fillingrespiration (resuscitation) enclosures or bags can be selected on thebasis of known maximum volumes, the volume actually delivered can varysubstantially among several operators, dependent upon factors such ashand size, number of hands used, technique, enthusiasm and fatigue.These variations have been shown to be as much as 60 percent of theoptimal tidal volume. Frequency can also vary between users.

Accordingly, it is considered an advance in the art to develop a singlemanual ventilation or resuscitation device that can be used on anypatient, regardless of individual factors such as physical condition,body/lung size, age and sex.

SUMMARY OF THE INVENTION

The present invention is a single manual ventilation or resuscitationdevice. The body of the device has rigid panels that encompass a sealedvolume with an inlet mechanism and an outlet mechanism. The rigid panelsare movable with respect to each other to allow the body to move betweenan uncompressed state and a compressed state. Once in compressed state avolume restoring mechanism is responsible to restore the volume from thecompressed state back to the uncompressed state.

One of the key objectives of the invention is to be able to hold thebody with one hand and to compress the body with that one hand. To meetthis objective, in one embodiment, the body is characterized by having adisplacement in a direction of a hand displacement (e.g. height of thebody) and at least one other direction (e.g. width of the body) otherthan this hand displacement. In another embodiment, the body ischaracterized by having a displacement in a direction of a handdisplacement (e.g. height of the body) and at least two other directions(e.g. width and length of the body) other than this hand displacement.The displacement in width and/or length is a function of the heightdisplacement and the geometry of the rigid panels.

The displacement of a panel are up to 85 mm, preferably up to 20-25 mm,and more preferably 10-15 mm. Some of the displacements would have tocomfortably fit between the thumb, one or more fingers and the web ofthe hand. In other words, the natural range of a grasping motion of ahand defines these displacements. The volume changes between the statesranges from 1 to 500 cc (infant and child), 250 to 1200 cc (child toadult), or 1 to 1400 cc (infant to adult).

A size adjuster is included to adjust one or more of the bodydisplacements to change the dimension of the uncompressed state orvolume. These size adjustments are up to 170 mm, and preferably up to 25mm. The objective of the size adjuster is to adjust the displacement tothen adjust the volume of e.g. the air delivered to an individual. Hencethe size adjuster is also referred to as a volume adjuster.

A frequency adjuster is included to adjust the time to restore thevolume from the compressed state to the uncompressed state or to adjustthe time to compress the volume from the uncompressed state to thecompressed state.

Feedback mechanisms could be included to provide tactile feedback,visual and/or audible feedback to the user. An example of tactilefeedback is to include tactile feedback areas, e.g., a flexiblematerial, to cover an opening in a rigid panel. These areas allow theuser to feel the compression force or lung resistance. These tactileareas are preferably sized and positioned to fit a thumb or one or morefingers of the user's hand. An example of a visual feedback mechanism isto provide the user feedback over the size (volume) adjustments or thefrequency. An example of an audible feedback mechanism is to provide theuser feedback over e.g. the compression speed, frequency, tidal volume,setting of the size (volume) adjuster or setting of the frequencycontrol adjuster.

One advantage of the device is the ergonomic fit of the body to a user'shand in both uncompressed and compressed state, which reduces fatigue tohand and/or arm muscles. Another advantage of the device is the abilityto adjust the volume and/or frequency so that the user can rely on amore or less constant tidal volume and tidal rate. Such ability allowsone to use the device on any patient, regardless of individual factorssuch as physical condition, body/lung size, age and sex. Yet anotheradvantage is that multiple devices could easily be stacked or nestedwith each other. In exemplary embodiments, the design and geometry couldbe configured to include such stacking or nesting capabilities.

BRIEF DESCRIPTION OF THE DRAWINGS

The objectives and advantages of the present invention will beunderstood by reading the following detailed description in conjunctionwith the drawings, in which:

FIG. 1 shows a three-dimensional perspective of the device according tothe present invention.

FIGS. 1A-1C are perspective views illustrating an embodiment of thedevice in an uncompressed (FIG. 1A), partially compressed (FIG. 1B), andfully compressed (FIG. 1C) state.

FIG. 2 shows a side view of the device according to the presentinvention.

FIG. 3 shows a top view of the device according to the presentinvention.

FIG. 4 shows a front view of the body of the device according to thepresent invention. The hook-up to a mask or intubation tube and outletis left out for clarity.

FIG. 5 shows a hand with dimensions for grasping and operating thedevice according to the present invention. FIGS. 5A and 5B illustratehand positions with the device in uncompressed and compressed statesrespectively.

FIG. 6 shows an exploded view of the device according to the presentinvention.

FIG. 7 shows an example of a size (volume) adjuster of the deviceaccording to the present invention.

FIG. 8 shows an example of a mechanism to restore the volume of the bodyof the device from a compressed state to an uncompressed state accordingto the present invention.

FIG. 9 shows an example of a frequency adjuster of the device accordingto the present invention.

FIG. 10 shows an example of a visual feedback mechanism according to thepresent invention.

FIG. 11 shows an example of a tactile feedback mechanism according tothe present invention.

FIG. 12 shows an example of stacking or nesting the devices of thepresent invention.

DETAILED DESCRIPTION

Although the following detailed description contains many specifics forthe purposes of illustration, anyone of ordinary skill in the art willreadily appreciate that many variations and alterations to the followingexemplary details are within the scope of the invention. Accordingly,the following preferred embodiments of the invention are set forthwithout any loss of generality to, and without imposing limitationsupon, the claimed invention.

A three-dimensional view of one example of the ventilation orresuscitation device 100 is shown in FIG. 1. In general, three parts canbe distinguished: a body 110, an input mechanism 120 to allow input ofe.g. air, oxygen, oxygen-enriched air, fluid, fluid mixture, gas, gasmixtures or any combination or derivative thereof in body 110, and anoutput mechanism 130 to output and deliver some or all of the inputtedcontent from body 110 to an individual via connector 132. Body 110distinguishes rigid panels that are movable with respect to each other.The key idea of the design of body 110 with rigid panels is to encompassa volume that can contain e.g. air, oxygen or oxygen-enriched air.Another key idea of the invention is to be able to hold the body of thedevice with one hand and to compress the body with that one hand. Theconcept as conceived in this invention, as will be clear from readingthe description, could be generalized to a body with rigid panelswhereby the body is characterized as having a displacement in adirection of a hand displacement and at least one other direction otherthan that particular hand displacement.

In the particular example of FIG. 1 body 110 distinguishes a pluralitypanels; e.g. panels forming the top, panels forming the bottom, andpanels for each side. More particularly, the following (main) panels canbe distinguished, i.e. panels 140A, 140B, 140D, 140E, 140F, 140G and140H, which are all visible in FIG. 1; panels 140D, 140E, 140F, 140G,140H, 140D′, 140E′, 140F′, 140G′, 140H′, which are all visible in FIG.2; panels 140A, 140B, 140C, 140D, 140E, 140F, 140G, 140H, 140D″, 140E″,140F″, 140G″ and 140H″, which are all visible in FIG. 3; and panels 140Cand 140C′, which are all visible in FIG. 4. Panels blocked from theviews in FIGS. 1-4, are 140A′, 140B′, 140D′″, 140E′″, 140F′″, 140G′″,140H′″. The relative positions and orientations of the panels blocked inthe figures is readily appreciated by a person of average skill in theart to which this invention pertains.

The movable parts or structures, indicated by 150 in FIGS. 1, 2 and 4could be living joints/hinges, snaps joints, fabricated flexures,heat-shrinked joints or flexures, welded joints, simple mechanicalhinges, pinned hinges, flexible hinges, or the like. The type of movablestructure depends on the type of manufacturing that is used to createthe rigid panels and body. Examples of different types of manufacturingof the panels, movable structures and body are e.g. blow molding, heatsealing, overmolding, the mechanical assembly of a rigid paneled chassiswith a flexible bladder or skin to form the body, coining to form livinghinges, assembly using gaskets as seals in hinges, injection molding,ultrasonic welding, radio frequency welding, dielectric welding, highfrequency welding, dipping, extrusion, spray coating, brush on, assemblyof adhesive backed sheets of various materials, and/or any type ofmanufacturing that results in a body with rigid panels that are movablewith respect to each other. A person of average skill in the art towhich this invention pertains would readily appreciate the differenttypes of manufacturing that can be used to make body 110, which areknown techniques in the mechanical and design engineering art. Inputmechanism 120 and output mechanism 130 could be manufactured andintegrated along with the manufacturing process of body 110 or laterassembled to body 110. The types of materials that can be used for therigid panels, input mechanism 120, output mechanism 130 and otherstructures of the device are e.g. polymers, plastic, polyethylene,polycarbonate, high impact polystyrene, K-resin, ABS, PVC, acetal,polypropylene, silicone, thermoplastic elastomers, thermoplasticrubbers, latex, fabrics, cardboard, or the like.

Body 110 has an uncompressed state where the panels are positioned tocreate a volume that can be filled with e.g. air, oxygen oroxygen-enriched air. From the uncompressed state, body 110 can change toa compressed state where the panels are moved with respect to each otherto decrease the volume with respect to the volume in the uncompressedstate. In other words, moving the rigid panels with respect to eachother from the uncompressed state to the compressed state, air, oxygenor oxygen-enriched air is outputted via output mechanism 130. Theuncompressed state could be at full expansion (i.e. maximum volume) orany intermediate state (See also size adjuster (volume) description).Restoring the volume allows entry of new air, oxygen or oxygen-enrichedair into the volume via input mechanism 120.

Body 110 has a height H, width W and length L (see FIGS. 1-4). Ingeneral, the state changes of body 110 could be characterized by theheight H of body 110 being larger in the uncompressed state compared tothe compressed state. FIGS. 1A-1C are perspective views illustrating anembodiment of the device in an uncompressed (FIG. 1A), partiallycompressed (FIG. 1B), and fully compressed (FIG. 1C) state. The heightchanges cause changes in width W and length L, which are smaller in theuncompressed state compared to the compressed state. The width andlength changes are a function of the height changes and the geometry ofpanels as a person of average skill would readily appreciate. It isfurther noted that the body could be characterized by having at leasttwo of the panels capable of rotating around substantially orthogonalaxes with respect to each other; consider e.g. panels 140F and 140Cwhich are both involved in the height changes, but given theirorientation, 140F is further related to the width changes, and 140C isfurther related to the length changes. One illustrative example is shownin FIGS. 1A-1C, where panels 140B and 140F rotate around axis 144, whichis substantially orthogonal to axis 142 which panel 140A rotates around.In summary, the body is characterized as having a displacement in adirection of a “hand displacement (i.e. height of body) and at least twoother directions (i.e. width and length of body) other than theparticular hand displacement (i.e. height of body).

The body could also have a higher or a smaller number of panels thanbody 110, as a person of average skill in the art to which thisinvention pertains would appreciate. For example, the panels could beassembled radially around central top and bottom panels and more panelscan be added, for example, 140F can be broken up into two or morepanels. An example of reducing panel numbers could be achieved byreducing 140A, 140B and 140C to only two panels. In the latter examplethe body would have height and width or length changes. In summary, suchbodies could be characterized as having a displacement in a direction ofa hand displacement (Le. height of body) and at least one otherdirection (i.e. width or length of body) other than the particular handdisplacement (i.e. height of body).

As mentioned above, one of the key objectives of the invention is to beable to hold the device with one hand and to be able to compress thebody with that one hand. To meet the objective the height and widthchanges in uncompressed and compressed state are therefore constrainedsince they would need to fit: (i) the hand of a user and (ii) thegrasping (or squeezing) range of motion of the user.

Furthermore, the thumb and one or more fingers are desirably positionedon body 110 to create a mechanical advantage (i.e. a large moment armwith respect to the point of rotation) when compressing the body. Such amechanical advantage meets another objective of the invention, which isto reduce fatigue of the hand muscles and potentially also the armmuscles.

FIG. 5 shows hand 500 with thumb 502, one or more fingers 504 and web ofthe hand 506 between which body 110 is typically held. Given a varietyof hand sizes (e.g. male, female, large and small) in mind one coulddetermine a reasonable range of motion and a comfortable fit to theuser's hand that constrains the height and width dimensions of body 110when moving between the uncompressed state (e.g., the hand positionillustrated in FIG. 5A) and a compressed state (e.g., the hand positionillustrated in FIG. 5B). For example, the height and width(displacement) changes of a single panel could be up to 85 mm,preferably 20-25 mm and more preferably up to 10-15 mm. The heightchanges would correspond to a hand displacement 520 in FIG. 5 and thewidth changes would correspond to a hand displacement 510 in FIG. 5. Aperson of average skill in the art to which this invention pertainswould readily appreciate that the geometry (dimensions and relativeangles) of the panels could be varied to meet the desired height andwidth (displacement) changes as well as the desired deliverable tidalvolume.

The length changes of a single panel could also be up to 85 mm but willnot be constrained by hand dimensions, but will be a variable indetermining the change in volume. The change in volume typically rangesfrom 1 to 1400 cc, preferably from 250 to 1200 cc, which covers tidalvolume ranges for children and adults. When the device is used forinfant or child purposes the volume changes are smaller and preferablyrange from 1 to 500 cc.

FIG. 6 shows an exploded view of an embodiment of the device of theinvention, In addition to the elements discussed above the devicefurther includes a main shaft 610 connected to output mechanism 130 andpositioned inside body 110. Main shaft 610 has narrow (cylindrical) end612 and a slot 614. The device further has a receiving shaft 620connected (or could be a single part) to input mechanism 630 and alsopositioned inside body 110. Receiving shaft 620 has an opening (notvisible in figure) sized to allow travel of main shaft 610 along thelength of receiving shaft 620. It further has a slot 622 preferably ofequal size as slot 614; slots 614 and 622 should also be aligned witheach other as will be understood when discussing volume recovery fromcompressed state to uncompressed state with respect to FIG. 8. Opening630 could be sized such that element 660 could be mechanically assembledby ultrasonic welding, snap fit, press fit, adhesive or any other knowntechniques in the mechanical and design engineering art. Element 660allows fitting and attachment of air/oxygen input devices. A fluttervalve 640 is fitted to the front opening of element 660 allowing e.g.air travel into receiving shaft 620 through opening 650 and then intobody 110. Element 660 further houses a size adjuster (also referred toas volume adjuster).

In general, the size adjuster of the device adjusts the length changes,width changes and/or height changes. The size adjuster serves thepurpose of easily adjusting the deliverable volume so that the user canrely of a fairly constant volume of deliverable e.g. air, oxygen oroxygen-enriched air. Adjusting the deliverable volume is important tocompensate for factors such as physical condition, body size, age, sex,etc.

In a preferred embodiment, size adjuster is integrated with inputmechanism 120, in particular with element 660, and adjusts the travellength of body 110. The size adjuster distinguishes an adjustment knob160 placed on top of element 660 and conveniently accessible to a user.The adjustment knob 160 is connected to an adjustment dial 162, which inthis example is positioned inside element 660; the connection could e.g.be through either valve 670 or 680.

FIG. 7 shows adjustment dial 162 with a number of slots 710, 712, 714,716 and 718. These slots are sized to fit narrow (cylindrical) end 612of main shaft 610 that is able to travel all the way through the openingof receiving shaft 620 (as well as through flutter valve 640; not shownin figure) when moving between uncompressed and compressed states. Bychanging adjustment knob 160, adjustment dial 162 is rotated aroundpivot 720 to a new slot position; this is typically done when the bodyis in compressed state. It is noted that size adjuster changes thedimension of the uncompressed state or volume.

Slots restrict the travel distance of main shaft 610 and therewithcontrol the deliverable volume to an individual. Slots sizes could be upto 170 mm to allow changes in length, and preferably are up to 25 mm.The number of slots and the sizes of the slots are selected to cover areasonable range of deliverable tidal volumes as a person skilled inpulmonary or emergency medicine would readily appreciate.

In the example of FIG. 7, the size (length) (volume) adjuster is placedoutside body 110. A person of average skill in the art to which thisinvention pertains would appreciate that the size adjuster can also bepositioned inside the body or intrinsic to the design of the body.Furthermore, the size adjuster could also be added for width or heightcontrol or any combination of height, length or width, or any otherdirection in a similar fashion as shown in FIG. 7.

Instead of a size adjuster with slots, one could design and integratedifferent types of mechanisms, which are all within the scope of thepresent invention. Examples of such variations are e.g. an adjustablethreaded stop for the main shaft, an element with chambers whereby eachchamber has grooves or each chamber has different depths, a slotted tubewith different positions of the slots to set travel constraints to themain shaft, deflecting stops that deflect when adjusted in an incorrector uncompressed state, a rack and pinion system with stops, ratchetingband (adjustable zip-tie), adjustable cam, a rotating dial of springloaded stops that deflect when adjusted in an incorrect or uncompressedstate, or any type of engineering mechanism that constrains the travelof the main shaft to control the volume output.

FIG. 8 shows an example of a volume restoring mechanism to restore thevolume from a compressed state back to the uncompressed state. Thiscould be accomplished by main shaft 610 traveling inside receiving shaft620 whereby (part of) slots 614 and 622 travel inline with each other.One site of slot 614 is connected to an opposite site of slot 622 byelement 810, which is e.g. an extension spring, plastic or rubber. Whenwe change from uncompressed state to compressed state, force is built-upin element 810. This force is then used to restore the body back to theuncompressed state when the user releases the compression force appliedto body 110. As a person of average skill in the art to which thisinvention pertains would appreciate, the volume restoring mechanismcould also be outside body 110 or intrinsic to body 110 (e.g. one couldhave the restoring force as an intrinsic property of the movable joints150). Other alternatives are a leaf spring mechanism inside body 110that builds up force when compressed or an extension spring/mechanismplaced inside body 110 but not integrated with the two shafts. Thevolume restoring mechanism could be adjusted using similar techniques asdiscussed for the size (volume) adjuster or it could be left to onesetting.

In an alternate embodiment, the device includes a frequency adjuster toset and control the time to: (i) restore the volume from a compressedstate back to the uncompressed state, and/or (ii) compress the volumefrom uncompressed state to a compressed state. The volume restoringmechanism as discussed above could be used as a frequencyadjuster/controller. However, in this scenario, the frequency control isthen still in hand of the user and not constrained by the device.Control over frequency is desired to enforce consistency in tidal volumerate. Therefore in another embodiment a frequency adjuster is added in asimilar fashion as the size adjuster.

A frequency control knob could be placed at the opposite site of element660 and implemented to adjust the frequency by e.g. a rack and pinionmechanism in combination with the main shaft to set the dampening oftravel of the main shaft, a rack and pinion mechanism coupled withrotationally resistant gears, a polymer escapement mechanism, a frictionbrake, a rotationally resistant ratchet wheel, or a track to deflect thetravel of the main shaft. All such mechanisms, which are known in themechanical and design engineering art, can be adjusted via a frequencycontrol knob to change the dampening of the travel of the main shaft,whereby an increase in dampening would result in a decrease infrequency. Similarly to the size adjuster mechanism, the frequencyadjuster could also be inside the body, outside the body or intrinsic tobody.

FIG. 9 shows an example of an embodiment of a frequency controlmechanism 900 that is accomplished by a ratchet mechanism 910 placed onfrequency control knob 920. Frequency control knob 920 can extend upfrom an identical knob to volume control knob 610, inverted andassembled to the bottom of the element 660. A ratchet wheel 930 can beassembled to frequency control knob 920 by e.g. a snap fit, a fasteneror any other means. Frequency control knob 920 can be rotated withratchet wheel 930 in line with the main rod's travel or outside of itstravel. The ratchet wheel's rotation can be dampened by multiple methodssuch as e.g. a friction insert, a roll pin, a coil or a watch spring, ahigh friction disc, or the like. There could be a variety of ratchetwheels along the circumference of frequency control knob 920 to adjustthe resistance to main rod 610 depending on the rotation direction offrequency control knob 920.

A visual feedback mechanism could be added to provide the user withvisual feedback (colors, markings, symbols, or the like) on theadjustments to size, travel of the main shaft, or the frequency. FIG. 10shows an example of a visual feedback mechanism for the size (volume)adjustments. Main shaft 610 could travel across a ruler 1010 designed toindicate e.g. minimum min, average avg, and maximum max deliverabletidal volume. The relative position of narrow end 612 of main shaft 610to markings 1012 could further assist in fine-tuning the desired volume.The visual feedback mechanism could be placed inside a body whereby thebody has a transparent part allowing a user to visualize the visualfeedback mechanism. A similar feedback mechanism could be applied forthe frequency.

One could further add an audible feedback mechanism (beeps, timers,commands, warnings, or the like) that provides feedback over thecompression speed, frequency, tidal volume, setting of the size (volume)adjuster or setting of the frequency control adjuster. Another exampleis to have click mechanism associated with the travel of the shaft(s)and/or changes in volume. The clicking sounds could also be used as atactile feedback; e.g. the clicks can be felt through the hand.

In still another embodiment, one could add tactile feedback areas 1130on one or more of panels such as panel 140B as shown in FIG. 11; 1110 isa top view and 1120 is a side view. Tactile feedback areas 1130 aresized and positioned to fit a thumb of a hand or one or more fingers(Le. on panel 140B′) of the hand. These areas are made of a flexiblematerial that is responsive to thumb or finger pressure as well aspressure from e.g. the air/oxygen inside the body. This will provide theuser additional feedback on the compression force and lung resistance.Deflection 1132 of flexible material 1130 with respect to the rigidpanel 140B illustrates the deflection caused by e.g. a finger duringcompression.

FIG. 12 shows an example of stacking or nesting multiple devices 100 ontop of each other. Stacking or nesting would be beneficial where spaceis limited, e.g. in an ambulance, and where multiple devices might berequired. In one example the design and geometry of the inlet mechanism,body and/or output mechanism allows them to nest with one another. Forexample, the top of the output mechanism could nest into the bottom ofanother output mechanism (a similar nesting could be established for theinput mechanism). Besides fitting the devices together, the device couldalso have features, e.g. ribs, indentations, VELCRO® (hook-and-loopfastener material), snap-mechanism, or the like, that preventside-to-side movement.

Although the present invention and its advantages have been described indetail, it should be understood that the present invention is notlimited to or defined by what is shown or discussed herein. Thedrawings, description and discussion herein show examples of theinvention and provide examples of using the invention. One skilled inthe art will realize that implementations of the present invention couldbe made without departing from the principles, spirit or legal scope ofthe present invention. Accordingly, the scope of the present inventionshould be determined by the following claims and their legalequivalents.

1. A ventilation or resuscitation device, comprising: a body with rigidpanels encompassing a sealed volume with an inlet mechanism and anoutlet mechanism, the rigid panels movable with respect to each other,wherein the body having an uncompressed state and a compressed state,wherein the body having at least a first displacement and a seconddisplacement, and wherein the second displacement is a function of thefirst displacement and the geometry of the panels, wherein a secondpanel is adjacent to and extends from a first panel in a firstdirection, a third panel is adjacent to and extends from the first panelin a second direction, and a fourth panel is adjacent to and extendsfrom the first panel in a third direction.
 2. The device of claim 1,further comprising a size adjuster to adjust one or more of the bodydisplacement changes between the states.
 3. The device of claim 2,wherein the size adjuster adjusts the one or more of the bodydisplacement changes up to 170 mm.
 4. The device of claim 1, furthercomprising a volume adjuster to adjust the volume changes between thestates.
 5. The device of claim 1, further comprising a volume restoringmechanism to restore the volume from the compressed state to theuncompressed state.
 6. The device of claim 1, further comprising afrequency adjuster to adjust the time to restore the volume from thecompressed state to the uncompressed state or to adjust the time tocompress the volume from the uncompressed state to the compressed state.7. The device of claim 1, wherein any of the body displacements of eachof the panels is up to 85 mm.
 8. The device of claim 1, wherein thechange in the volume between the states ranges from 1 to 500 cc.
 9. Thedevice of claim 1, wherein the one or more of the body displacementsbetween the states comfortably fits between a thumb of a hand, one ormore fingers of the hand and the web of the hand.
 10. The device ofclaim 1, wherein the one or more of the body displacements between thestates is defined by the natural range of a grasping motion of a hand.11. The device of claim 1, further comprising a feedback mechanismconfigured to provide feedback on one or more of the frequency ofcompression of the device and the tidal volume delivered.
 12. The deviceof claim 1, further comprising a visual feedback mechanism.
 13. Thedevice of claim 12, wherein the body comprises a transparent sectionconfigured such that the visual feedback mechanism is visible fromoutside of the body of the device.
 14. The device of claim 1, furthercomprising an audible feedback mechanism.
 15. The device of claim 1,further comprising stacking or nesting capabilities for stacking thedevices.
 16. The device of claim 1, wherein the change in the volumebetween the uncompressed state and the compressed state ranges from 250to 1200 cc.
 17. The device of claim 1, wherein the change in the volumebetween the uncompressed state and the compressed state ranges from 1 to1400 cc.
 18. The device of claim 1, wherein the panels are operablyconnected by one or more movable structures.
 19. The device of claim 1,wherein the movable structures comprise hinges.
 20. The device of claim1, wherein the first panel and the second panel rotate around a firstaxis, and wherein the third panel rotates around a second axis, whereinthe second axis is substantially orthogonal to the first axis.